Tag: medication

Posted in psychology, Voices

The Schizoaffected Sense

Posted on by alidware

Hey everyone, I have some exciting news.

I decided since this blog has mostly turned into book reviews and travel tips, I’ve moved my mental health segments into a podcast, aptly named The Schizoaffected Sense. Right now all episodes 1-4 are available for listening at this Spotify link.

If you’d like to give it a listen, we talk about self-care, medication, and being mixed race; if you didn’t know already, my mother is white and my father is black and while that’s not uncommon today, I didn’t get to grow up around a lot of kids like me. I knew two, in fact.

Just two.

I share some deeply personal stories in the episode about medication, so if you’re squeamish or triggered by talk of suicide, consider having some support on standby while you listen.

When you do listen, come on over to my instagram @alilivesagain or come back to this post and comment what you think. The good, the bad, and the ugly: I’m here for all of it.

P.S my recording studio right now is my car, so don’t expect perfect audio. I had to do a lot of mixing just to get it to sound as it does.

Also, my bad drawings prevail! Muahahahaha!

Until next time.

Don’t forget to hit that follow button and join me, again, on my instagram @ alilivesagain, on twitter @ happyschizobs and on Tok Tok @alisaysno.

Posted in Peer Support, science, Supporting Friends/Family, Therapy

How To (Gently) Encourage Your Friend to Get On Medication.

Posted on by alidware

Step 1:

Don’t.

It’s that simple.

Why Are We Talking About This?

There are too many questions on social media of people asking Pop-Advocacy sites and people with lived experience how they should convince their friend to get back on medication. Let’s be clear that this is often out of love, concern, pain, and desperation. If you are reading this and have a friend or loved one you believe should be on medication, don’t give up on reading this just yet. This article is not here to bash you, punish you, or guilt you. It’s here for guidance.

We’re talking about this because mental health conditions strike unexpectedly at times, roll in and out of our lives in episodes, and put stress on everyone effected. We’re talking about this because often healthy boundaries get left in the dark when we’re all under so much stress. Those of us struggling can become dependent and feel helpless, while those of us who feel responsible for the well-being of our loved-one feel guilt that we can’t make this pain go away.

We’re talking about this to make it easier on everyone.

Objective Conversation About Medication

One of the reasons pestering your loved one to get on medication is often a losing battle is because there is absolutely zero objective conversation when it comes to medication. Often it is “take this because it’s good for you” instead of “What are the benefits of you taking this? What are the consequences? What can I/we do that can help you with whatever your decision is?”

The “take it because I know what’s good for you” argument is given subtly (or sometimes overtly) in the professional setting. To come home and hear it again, aggressively or compassionately, is all it takes to send someone over the edge, or push them farther away from pharmaceuticals.

There is no consideration of what the person who actually has to take the medication feels. If they feel stable enough off the medication and people constantly tell them they should get back on to avoid the ups and down or voices or anxiety, it creates a lot of self-doubt, a lot of fear, and another sense of helplessness. That can feed depression, it can feed anxiety, it can egg on voices.

If they don’t appear stable, if they lost their job or can’t maintain one, if they are having suicidal thoughts or talking to themselves often, and they still don’t want medication, telling them they should get on some can be seen as forceful and power-hungry. When we’re in the throws of an episode or just having a bad day–those exist for everyone, you know, not necessarily indicative of a mental breakdown–anyone who approaches with concern in the form of demands or a “hero” mentality will seem like an enemy. Rather than feeling the love you have for us, we’ll only feel your disapproval. We’ll feel like something is wrong with us or we’ll feel attacked. That could feed depression, anxiety, and could exacerbate delusions.

Boundaries

This is where having boundaries comes in super handy.

The thing about watching a loved one struggle is that we put a lot of their wellness on our shoulders. The thing about their wellness is that it’s not our responsibility.

That is not meant harshly.

People have choice. They are allowed to struggle. In fact, struggle can result in life transformation. Sometimes if we’re blocked from feeling, if we’re blocked from experiencing what we should, we may not come across that one moment in our lives that tells us: “I need to make some changes“.

You are not that voice for your loved one.

And so a boundary would be limiting your involvement. Resist the urge to help them at any time, particularly if they aren’t doing much to work on themselves.

But, give them space. Make statements like “You’re doing well/unwell today. What’s changed?” and when they answer, listen objectively. Avoid judging statements like “well, if you got back on your medication this wouldn’t be such a big deal” or “look, it’s not my fault you don’t want to do anything to feel better”. Arguing will increase cortisol levels in both of you.

If you feel bullied into helping your loved one, or they often use their condition as a means to exploit your help, stop blaming this behavior on the condition. Most often this is a learned behavior and a result of learned helplessness. Being angry is often a result of feeling like a burden, feeling helpless and out of control, but that doesn’t mean you deserve to be verbally or physically attacked, nor does it mean you need to accept that treatment. Medication will often not stop this behavior.

Louder Now: MEDICATION WILL NOT STOP THIS BEHAVIOR.

And if it does, it’s only because of the sedative seffects.

And so regardless, the behavior is never addressed. Your trauma is never addressed. Your loved one can continue to be angry, feel misunderstood and undervalued, and you will continue to feel like a doormat and blame their “sickness”. It’s quite a cycle, huh?

So what DO you do?

You listen.

Understand that this is not your responsibility, nor is it your struggle.

You’re concerned, you’re worried, fearful, angry, confused. So is your loved one.

Maybe they don’t need a solution right now. Maybe they just want to feel supported and understood and heard. And it’s time to consider if you’re willing to be more of a supportive force and less of a hero.

This isn’t debate class. Having a stellar argument won’t result in discussion, it’ll result in fallout. You want discussion. Go in objectively. Go in with the conception that this is not your mind nor your body, but it is the mind and body of someone you care deeply for. Go in understanding that they have the right to choose and you have the right to your beliefs and discuss both. You may have to agree to disagree and just enjoy each other’s point of view.

If you’re really invested, research all the advantages and disadvantages of medication. Read stories of people who have been helped and hurt by medication, read stories of those who have successfully lived off of medication. Read psychology research papers (not secondary sources). If this part is confusing to you, read this.

Think of a time in your life when you made a decision or something happened which transformed your perception of yourself, the world, and the people around you. Now imagine that never happened.

Controlling someone’s choices can block transformative experiences. Life isn’t debate class.

For updates on posts, research, and conversations, follow me:

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Twitter: @philopsychotic

If you enjoyed this post, please share, like and follow ThePhilosophicalPsychotic. I appreciate every reader and commentator. You give me more reason to continue this joyous hobby.

Posted in advocacy, science

How Important Are Your Psychiatric Medications?

Posted on by alidware

This question is for all of us, including myself, without much judgement. There are those who quit their medication and are fine, those who quit and are not fine, those who want off but are worried about withdrawal (which can trigger an upswing of serious symptoms again), and there are those who want off but their doctors disagree.

For those with any diagnosis related to psychosis, one thing you’re told especially is to stay on your meds. The reasons for why are a little less clear. This is what research says.

The Papers:

I found two articles on this topic, both Meta-Analysis (they’ve collected a group of studies and used statistics to quantify the average results of all the studies)

They both discuss studies assessing whether long term antipsychotic treatment maintains sufficient and healthy remission for individuals experiencing first-episode psychosis. There are two conclusions you will often find when searching databases for this kind of research: 1) long term medication works and 2) long term medications interferes with progress. One of these analyses kinds of lands in the middle, and the other is 100% supportive of medication.

We’ll discuss possible reasons why both valid analyses come to such different conclusions, and what this means for us.

1. Maintenance Antipsychotic Treatment Versus Discontinuation Strategies Following Remission From First Episode Psychosis: Systematic Review.

This analysis follows studies which look to understand the risks of maintenance (Long-Term usage) compared to risks of discontinuing medication AFTER remission in first episode psychosis. Seven studies were included.

Now, they looked for specific things, particularly comparing hospital relapse rates and hospital admission rates of those First Episode Psychosis individuals who maintained antipsychotic medication to those who were discontinuing their medication. For the studies which used an intermittent treatment approach, the participants medication was discontinued by 50% every two weeks. For those exhibiting prodromal symptoms, medication was reintroduced. In the crisis-based approached, medication was only reintroduced upon a full-blown episode.

Ultimately, higher relapse rates and hospitalization rates were seen in those discontinuing medication.

Two of the studies provided information on psychosocial outcomes like employment status or quality of life measurement.

I encourage you to read the analysis for yourself. I found it shocking that things like an individual’s place in society, their level of function in their community, their sense of purpose, the amount of support available, was not included. Yes, medication discontinuation seems to increase the likelyhood of relapse according to this analysis, but what could be the reason for this? Only medication? Or what about lack of support? What about the fact that tapering off medication with 50% of the dosage broken down every two weeks is indeed quite fast? Perhaps the speed effected the results of that one study.

Another rather glaring fact which makes me worry for the integrity of the analysis is the possible bias of the authors. One of them recieved support from Janssen-Cilag (think Haldol) and Otsuka Pharmaceuticals (think Abilify). This author also was an investigator on trials funded by AstraZeneca (think Seroquel) and Janssesn-Cilag. He holds a Pfitzer (think Prozac) Neurosciences Research grant.

Another author received sponsorship from Otsuka to attend a conference, and has shares in GlaxoSmithKline (think Paxil) and AstraZeneca. The last author attended meetings supported by Sunovion Pharmaceuticals (think Lunesta).

The only inherent problem with this is conflict of interest. There are times many researchers have been caught falsifying data or misreporting data with the agreement that they would get paid extra by the pharmaceutical companies funding their research. This is also common in the world of regular medical science and was particularly a catalyst for the Opiate Epidemic. Think Purdue Pharma.

This is the largest issue medical science faces today.

2.Improving Outcomes of First-Episode Psychosis: an Overview

This overview looks at possible prevention of psychosis, which is curious in itself. You can read in the paper all the different steps and stages they present which could, with further study, advance the way psychosis is treated and/or identified in an individual. They acknowledge that despite all the preventative strategies currently in place, often people will fall back into old symptoms following their first episode.

They updated a 3-trial meta-analysis to 12 trials and found that relapse rates while undergoing preventative care strategies were, on average, lower than relapse rates of those undergoing standard treatment. However, they found that there was no substantial meta-analysis support that showed integrative preventative strategies significantly improved anyone’s potential rate of relapse in comparison to a standard level of care.

They also found that the hypothesis that each new psychotic episode “damages” the brain or is “neurotoxic” to the brain and therefore “progresses the disease” has no significant empirical evidence to support it. This hypothesis is known as the “neurotoxic hypothesis of psychosis” and I’ve heard people cite it quite often.

The overview goes on to discuss future studies and cannot conclude that any one way is the correct way. They advise against using certain medical strategies that observe and study physical illness to observe, study, and treat mental health conditions; the brain varies more so than the body in more ways than one, and to assume that both can be treated equally is pretty far fetched.

There is a lot of theory in this overview and I’m not sure how much of it could be put into practice. They discuss some ways in the article, if you’re interested, including areas of support. Accordingly, their authors were not previously supported by any pharmaceutical companies.

And so where does this leave us? We have empirical evidence that medication can halt a crisis, but it is unclear, according to the second study, if we’re simply prolonging the inevitable or helping cease the progression of something. In the case of prolonging the inevitable, it would seem more humane to let people ride through the torture and support them in other ways. In the case of ceasing the progression of something–well, it seems like we’d have more reliable and verifiable data if that were the reality.

I stopped medication because I don’t like uncertainty. And the truth of medication is uncertain. I stopped medication because I don’t like being lied to. And much of medication research and marketing is based in lies, even small ones.

This may not be the path for you. What makes your medication important to you? What makes it torturous for you? Do the risks outweigh the benefits? Would you like to discontinue them some day?

Would you like to continue the conversation accompanied by beautiful photos? Great! Follow me:

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Posted in Emotions, Peer Support, psychology, Uncategorized

Quick Post

Posted on by alidware

Hey everyone.

In an effort to keep this blog rolling and the momentum up, I just wanted to send out an update that because of some bad obsessive anxiety and the resulting paranoia, I won’t be able to crank out my usual post for the day. It was going to be about who we let speak for us in mental health advocacy.

As much as I’d love to do that, I need to take some time today and possibly tomorrow to get myself well again.

In the meantime though, please feel free to give a read to yesterday’s post, “What Is Trauma?” And any of the popular featured posts!

If anyone wants to send some positive vibes on my social media accounts or below In the comments, that’s welcome too. I’ll be tweeting and posting an actual explanation on my Instagram, if you’re curious.

I will resume my usual schedule on Thursday, Jan 9th.

Here’s to all of our wellness and the hard work it takes for us to sustain stability. Thank you to my newly dedicated readers and commentators. You’ve truly been another driving force for me these last few months.

If you’d like to join me on social media, they’re here:

Instagram: @Written_in_the_photo

Twitter: @Philopsychotic

Posted in Emotions

To Process Emotions

Posted on by alidware

When I stopped seriously blogging about two years ago, it was abrupt and painful. Painful because I missed the writing community of almost five years which had enjoyed stories and laughs and tears and memories and traumas alongside me. They were there when I got my first car. They were there when I quit each job I got. They were there when I became employed at a Peer Respite house. They were there in my largest transformations of self.

Also painful because I was cracking up. Breaking down. In the hospital, confused and somewhat oddly satisfied in my terror of life. I felt alive again in a twisted way. I felt targeted and special and immortal and genius and connected to something greater than myself.

I posted every once in a while, but lost my follower’s attention. I created a slough of new sites, but WordPress changed so much of their format that I got frustrated trying to adapt. So, I went dark.

I told myself I’d be back only when I felt secure in myself. I’d be back only when I knew I had something important to say. I have something important to say.

This journey through depression and delusion and anxiety has given me new insights on darkness. Its introduced me to the true duality of nature so described in daoism. It’s roughly coddled me into accepting not only myself but all of life.

At the beginning of the pain, before I even worked at the respite house, a voice kept telling me “dead man walking”. Considering I’m a woman, it kind of cracked me up and also simultaneously terrified me; someone, something, was coming to kill me I thought. But I don’t think he predicted my future. I think he commented on my present. I was dead. I enjoyed nothing. I faked smiles. I practiced expert avoidance. I ignored myself and my inner processes because they scared me and because of that fear those inner processes found a way to express themselves for the first time in both of our lives. That way was voices, beliefs, depressions, a mania, panic attacks, and the underlying feeling of being broken.

I could talk about childhood stuff here. I could talk about medication and homelessness and the trauma of school. But I spent years reiterating that on my previous blog. I’ve spent time reiterating it to friends and therapists. And now, I can sum it all up in one word: fear.

I feared everything, for many reasons. I feared life. I feared being sad. I feared being happy because sadness came after. I feared anxiety, I feared death, I feared fear.

I think many of us go into therapy or other treatments confused on what “processing emotions” means. I think some therapists and psychiatrists who have never really gone through that heavy process are also confused on what it means. So they blurt it because they’re supposed to, it’s part of the script.

Processing emotions for me meant more than just talking about them and feeling them. It meant not telling myself “tomorrow will be better” or “this is temporary” or “I’ll be happy some day”. It meant not telling myself “you need to get up”. It meant greeting darkness with a handshake and respecting the space it needed within me. The darkness is lonely, too.

It meant sharing my body and my mind with panic and voices and fear and setting boundaries with them; if we all have to live in here together, we need to communicate and I can’t hold the power. But neither can you.

It meant getting comfortable with uncertainty. There is no standard “life”. My experiences don’t make life worse than what life should be, they don’t make life better than what life should be because life doesn’t have a designated “should”. It doesn’t have a designated “have to”. It’s just there.

It meant veering from my psychology degree and studying philosophy, a bit of physics, and leafing through neuroscience articles. It meant studying research. It meant, for me, getting off medication, and really feeling ALL of myself.

I’m sure most people have heard of the double-slit experiment in physics. I remember hearing about it for the first time as I sat high as a kite in High School chemistry. You learn the conclusion is that photons (and other particles) behave as both a wave and a particle, given the observed interference pattern. What high school teachers don’t talk much about is that the reason we come to that conclusion and label it as a reasonable consensus is because, as of right now, we’ll never know if we’re wrong.

We can’t see a single photon pass through anything with the naked eye. And so when we don’t observe it with a camera, when we can’t see what’s happening, the photon behaves as a single photon. The camera we use to observe this particle has a tiny light. That tiny light is a confounding variable–it could be affecting the particle’s behavior. Or maybe it isn’t. But, because we can never see for ourselves with a naked eye, we’ll never know. That’s the paradox, and part of the foundation of the Uncertainty Principal.

We’ll never know. We’re limited in this life we have, and when we’re not okay with that, we run ourselves exhausted trying to fix what isn’t broken.

I’m not scared of darkness anymore. What is there to be scared of?